scholarly journals Lugano Lymphoma Response Classification No Response/Stable Disease by CT

2020 ◽  
Author(s):  
Keyword(s):  
Stable Disease ◽  
Response Classification

scholarly journals Detection of EGFR Activating and Resistance Mutations by Droplet Digital PCR in Sputum of EGFR-Mutated NSCLC Patients

2021 ◽  
Vol 15 ◽  
pp. 117955492199307
Author(s):  
Klaus Hackner ◽  
Anna Buder ◽  
Maximilian J Hochmair ◽  
Matthaeus Strieder ◽  
Christina Grech ◽  
...  
Keyword(s):  
Stable Disease ◽  
Progressive Disease ◽  
Kinase Inhibitor ◽  
Diagnostic Yield ◽  
Resistance Mutation ◽  
Egfr Mutations ◽  
Plasma Samples ◽  
Percent Agreement ◽  
Nsclc Patients ◽  
Egfr Mutated

Background: Proof of the T790M resistance mutation is mandatory if patients with EGFR-mutated non-small cell lung cancer (NSCLC) progress under first- or second-generation tyrosine kinase inhibitor therapy. In addition to rebiopsy, analysis of plasma circulating tumor DNA is used to detect T790M resistance mutation. We studied whether sputum is another feasible specimen for detection of EGFR mutations. Methods: Twenty-eight patients with advanced EGFR-mutated NSCLC were included during stable and/or progressive disease. The initial activating EGFR mutations (exon 19 deletions or L858R mutations) at stable disease and at progressive disease (together with T790M) were assessed in simultaneously collected plasma and sputum samples and detected by droplet digital polymerase chain reaction (ddPCR). Results: Activating EGFR mutations were detected in 47% of the plasma samples and 41% of sputum samples during stable disease, and in 57% of plasma samples and 64% of sputum samples during progressive disease. T790M was detected in 44% of the plasma samples and 66% of the sputum samples at progressive disease. In ddPCR T790M-negative results for both specimens (plasma and sputum), negativity was confirmed by rebiopsy in 5 samples. Concordance rate of plasma and sputum for T790M was 0.86, with a positive percent agreement of 1.0 and a negative percent agreement of 0.80. Conclusions: We demonstrated that EGFR mutation analysis with ddPCR is feasible in sputum samples. Combination of plasma and sputum analyses for detection of T790M in NSCLC patients with progressive disease increases the diagnostic yield compared with molecular plasma analysis alone.

Operabilität und pathologisches Ansprechen des Lungenkarzinoms nach neoadjuvanter Therapie mit Immun-Checkpoint-Inhibitoren

2020 ◽  
Vol 41 (10) ◽  
pp. 695-701
Author(s):  
E. Lücke ◽  
C. Ganzert ◽  
S. Föllner ◽  
A. Wäsche ◽  
D. Jechorek ◽  
...  
Keyword(s):  
Stable Disease ◽  
Neoadjuvante Therapie ◽  
Checkpoint Inhibition ◽  
Pet Ct

Zusammenfassung Hintergrund Eine Blockade von Immun-Escape-Mechanismen (z. B. PD1 /PD-L1) mit Immun-Checkpoint-Inhibition (ICI) kann das Überleben von Patienten mit fortgeschrittenem NSCLC wesentlich verlängern und ausgeprägte Remissionen induzieren. Eine neoadjuvante ICI bei Patienten mit resektablem (UICC-Stadium III) oder oligometastasiertem (UICC-Stadium IVA) NSCLC wurde bisher kaum untersucht. Patienten/Methoden Es wurden Biopsien von Patienten mit lokal fortgeschrittenem oder oligometastasiertem NSCLC untersucht. Es erfolgte bei einer PD-L1-Expression > 50 %, gutem ECOG-Status und zu erwartender Operabilität die ICI-Applikation und nach ca. 4 Wochen die thoraxchirurgische OP. Alle Patienten erhielten ein komplettes Staging einschließlich PET-CT, cMRT und endobronchialem Ultraschall. Es wurden die Verträglichkeit, das radiologische und histologische Tumoransprechen und das chirurgische Outcome analysiert. Ergebnisse 4 Patienten (2 männlich, 2 weiblich, Alter 56–78 Jahre, n  =  3 Adenokarzinom, n  =  1 Plattenepithelkarzinom) erhielten präoperativ einen ICI. Alle Patienten hatten lokal fortgeschrittene Tumore, und die mediastinalen Lymphknoten waren in 3 Fällen positiv. Bei einem Patienten lag eine isolierte Hirnmetastase vor, welche stereotaktisch radiotherapiert wurde. Alle Patienten erhielten präoperativ komplikationslos 2–6 Zyklen eines ICI (3 × Pembrolizumab; 1 × Atezolizumab). Dies führte nicht zu einer Verzögerung der OP. Nach iRECIST zeigten 3 Tumore eine partielle response (PR), und ein Patient wies ein stable disease (SD) auf. Alle Tumore wurden komplett reseziert, und die OP erwies sich trotz inflammatorischer Veränderungen als technisch unproblematisch. Es gab keine behandlungsbezogene Morbidität oder Mortalität und keine perioperativen Komplikationen. In den Resektaten waren jeweils 2-mal ein komplettes pathologisches Ansprechen (CPR), Regressionsgrad III nach Junker, und 2-mal ein Regressionsgrad IIa nach Junker nachweisbar. Das mittlere Follow-up betrug 12 (1–24) Monate. Die PPR-Patienten entwickelten entweder Fernmetastasen nach 6 Monaten oder ein Lokalrezidiv nach 4 Monaten. Die CPR-Patienten sind bisher rezidivfrei. Schlussfolgerungen Eine neoadjuvante Therapie mit ICI ist gut verträglich und kann bei ausgewählten Patienten eine komplette Tumorremission induzieren. Die Behandlung hat keinen negativen Einfluss auf den chirurgischen Eingriff. Die Prognose ist vielversprechend bei CPR und eingeschränkt bei PPR.

scholarly journals Radiomics analysis for predicting pembrolizumab response in patients with advanced rare cancers

2021 ◽  
Vol 9 (4) ◽  
pp. e001752
Author(s):  
Rivka R Colen ◽  
Christian Rolfo ◽  
Murat Ak ◽  
Mira Ayoub ◽  
Sara Ahmed ◽  
...  
Keyword(s):  
Partial Response ◽  
Stable Disease ◽  
Progressive Disease ◽  
Tumor Response ◽  
Complete Response ◽  
Classification Model ◽  
P Value ◽  
Rare Cancer ◽  
Rare Cancers ◽  
Contrast Enhanced Ct

BackgroundWe present a radiomics-based model for predicting response to pembrolizumab in patients with advanced rare cancers.MethodsThe study included 57 patients with advanced rare cancers who were enrolled in our phase II clinical trial of pembrolizumab. Tumor response was evaluated using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and immune-related RECIST (irRECIST). Patients were categorized as 20 “controlled disease” (stable disease, partial response, or complete response) or 37 progressive disease). We used 3D-slicer to segment target lesions on standard-of-care, pretreatment contrast enhanced CT scans. We extracted 610 features (10 histogram-based features and 600 second-order texture features) from each volume of interest. Least absolute shrinkage and selection operator logistic regression was used to detect the most discriminatory features. Selected features were used to create a classification model, using XGBoost, for the prediction of tumor response to pembrolizumab. Leave-one-out cross-validation was performed to assess model performance.FindingsThe 10 most relevant radiomics features were selected; XGBoost-based classification successfully differentiated between controlled disease (complete response, partial response, stable disease) and progressive disease with high accuracy, sensitivity, and specificity in patients assessed by RECIST (94.7%, 97.3%, and 90%, respectively; p<0.001) and in patients assessed by irRECIST (94.7%, 93.9%, and 95.8%, respectively; p<0.001). Additionally, the common features of the RECIST and irRECIST groups also highly predicted pembrolizumab response with accuracy, sensitivity, specificity, and p value of 94.7%, 97%, 90%, p<0.001% and 96%, 96%, 95%, p<0.001, respectively.ConclusionOur radiomics-based signature identified imaging differences that predicted pembrolizumab response in patients with advanced rare cancer.InterpretationOur radiomics-based signature identified imaging differences that predicted pembrolizumab response in patients with advanced rare cancer.

scholarly journals Response: Classification of the Arthropod Fuxianhuia

Science ◽  
1996 ◽  
Vol 272 (5262) ◽  
pp. 747-748 ◽  
Author(s):  
G. D. Edgecombe ◽  
L. Ramskold
Keyword(s):  
Response Classification

scholarly journals Atypical, Non-V600 BRAF Mutations as a Potential Mechanism of Resistance to EGFR Inhibition in Metastatic Colorectal Cancer

2019 ◽  
pp. 1-10 ◽  
Author(s):  
Benny Johnson ◽  
Jonathan M. Loree ◽  
Alexandre A. Jacome ◽  
Shehara Mendis ◽  
Muddassir Syed ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Stable Disease ◽  
Kinase Activity ◽  
Class Ii ◽  
Activity Level ◽  
Class Iii ◽  
Braf Mutations ◽  
Egfr Inhibition ◽  
Mechanism Of Resistance

PURPOSE Atypical, non-V600 BRAF ( aBRAF) mutations represent a rare molecular subtype of metastatic colorectal cancer (mCRC). Preclinical data are used to categorize aBRAF mutations into class II (intermediate to high levels of kinase activity, RAS independent) and III (low kinase activity level, RAS dependent). The clinical impact of these mutations on anti-EGFR treatment efficacy is unknown. PATIENTS AND METHODS Data from 2,084 patients with mCRC at a single institution and from an external cohort of 5,257 circulating tumor DNA (ctDNA) samples were retrospectively analyzed. Overall survival (OS) was calculated using Kaplan-Meier and log-rank tests. Statistical tests were two-sided. RESULTS BRAF mutations were harbored by 257 patients, including 36 with aBRAF mutations: 22 class III, 10 class II, four unclassified. For patients with aBRAF mCRC, median OS was 36.1 months, without a difference between classes, and median OS was 21.0 months for patients with BRAFV600E mCRC. In contrast to right-sided predominance of tumors with BRAFV600E mutation, 53% of patients with aBRAF mCRC had left-sided primary tumors. Concurrent RAS mutations were noted in 33% of patients with aBRAF mCRC, and 67% of patients had microsatellite stable disease. Among patients with aBRAF RAS wild-type mCRC who received anti-EGFR antibodies (monotherapy, n = 1; combination therapy, n = 10), no responses to anti-EGFR therapy were reported, and six patients (four with class III aBRAF mutations, one with class II, and one unclassified) achieved stable disease as best response. Median time receiving therapy was 4 months (range, 1 to 16). In the ctDNA cohort, there was an increased prevalence of aBRAF mutations and subclonal aBRAF mutations ( P < .001 for both) among predicted anti-EGFR exposed compared with nonexposed patients. CONCLUSION Efficacy of anti-EGFR therapy is limited in class II and III aBRAF mCRC. Detection of aBRAF mutations in ctDNA after EGFR inhibition may represent a novel mechanism of resistance.

scholarly journals Dendritic cell–based immunotherapy targeting Wilms’ tumor 1 in patients with recurrent malignant glioma

2015 ◽  
Vol 123 (4) ◽  
pp. 989-997 ◽  
Author(s):  
Keiichi Sakai ◽  
Shigetaka Shimodaira ◽  
Shinya Maejima ◽  
Nobuyuki Udagawa ◽  
Kenji Sano ◽  
...  
Keyword(s):  
Dendritic Cell ◽  
Malignant Glioma ◽  
Stable Disease ◽  
Wilms Tumor ◽  
Malignant Gliomas ◽  
Tumor Lysate ◽  
Dc Vaccine ◽  
Pulsed Dc ◽  
Wilms Tumor 1 ◽  
Vaccination Therapy

OBJECT Dendritic cell (DC)-based vaccination is considered a potentially effective therapy against advanced cancer. The authors conducted a Phase I study to investigate the safety and immunomonitoring of Wilms’ tumor 1 (WT1)-pulsed DC vaccination therapy for patients with relapsed malignant glioma. METHODS WT1-pulsed and/or autologous tumor lysate-pulsed DC vaccination therapy was performed in patients with relapsed malignant gliomas. Approximately 1 × 107 to 2 × 107 pulsed DCs loaded with WT1 peptide antigen and/or tumor lysate were intradermally injected into the axillary areas with OK-432, a streptococcal preparation, at 2-week intervals for at least 5–7 sessions (1 course) during an individual chemotherapy regimen. RESULTS Ten patients (3 men, 7 women; age range 24–64 years [median 39 years]) with the following tumors were enrolled: glioblastoma (6), anaplastic astrocytoma (2), anaplastic oligoastrocytoma (1), and anaplastic oligodendroglioma (1). Modified WT1 peptide–pulsed DC vaccine was administered to 7 patients, tumor lysate-pulsed DC vaccine to 2 patients, and both tumor lysate–pulsed and WT1-pulsed DC vaccine to 1 patient. The clinical response was stable disease in 5 patients with WT1-pulsed DC vaccination. In 2 of 5 patients with stable disease, neurological findings improved, and MR images showed tumor shrinkage. No serious adverse events occurred except Grade 1–2 erythema at the injection sites. WT1 tetramer analysis detected WT1-reactive cytotoxic T cells after vaccination in patients treated with WT1-pulsed therapy. Positivity for skin reaction at the injection sites was 80% (8 of 10 patients) after the first session, and positivity remained for these 8 patients after the final session. CONCLUSIONS This study of WT1-pulsed DC vaccination therapy demonstrated safety, immunogenicity, and feasibility in the management of relapsed malignant gliomas.

scholarly journals Five years of stable disease with maintenance therapy using bevacizumab and tamoxifen in a patient with metastatic breast cancer

2015 ◽  
Vol 16 (4) ◽  
pp. 493-497
Author(s):  
Giandomenico Roviello ◽  
Edoardo Francini ◽  
Armando Perrella ◽  
Letizia Laera ◽  
Maria Antonietta Mazzei ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Maintenance Therapy ◽  
Stable Disease ◽  
Metastatic Breast

Monocyte activation in multiple sclerosis

1998 ◽  
Vol 4 (3) ◽  
pp. 162-168 ◽  
Author(s):  
Anthony T Reder ◽  
Kursad Genc ◽  
Paul V Byskosh ◽  
Anna Maria Porrini
Keyword(s):  
Multiple Sclerosis ◽  
Stable Disease ◽  
Immune Therapy ◽  
Surface Proteins ◽  
Clinical Activity ◽  
Blood Monocytes ◽  
Monocyte Activation ◽  
Cns Inflammation ◽  
Activation Markers ◽  
Peripheral Blood Monocytes

Monocytes, macrophages, and microglia have a central role in the CNS inflammation of MS. Monocytes are important in the earliest events in MS. Peripheral blood monocytes secrete prostaglandins before MS attacks. During clinical activity monocyte activation markers increase and IL-1 and TNF-a levels are elevated. Other monocyte products such as IL-10 reduce inflammation. IL-10 mRNA in MNC is increased during stable disease. Manipulation of monokine secretion and expression of monocyte surface proteins are reasonable approaches for immune therapy of MS.

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